Corneal Cross-linking to Halt the Progression of Keratoconus and Corneal Ectasia: Seven-Year Follow-up

O’Brart, David; Patel, Parul; Lascaratos, Gerassimos; Wagh, Vijay B; Tam, Connan; Lee, Jennifer; O'Brart, Naomi A. L.

doi:10.1016/j.ajo.2015.08.023

Cited by 118 publications

(105 citation statements)

References 32 publications

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“…30 Clinical data, with a follow-up of up to 10 years, available on RF/UV-A CXL, show persistent stabilization of keratoconus. [22][23][24] In summary, WST-D/NIR treatment resulted in significant and long-lasting corneal stiffening that sustains for at least 8 months after treatment, bridging the period until natural agerelated stiffening occurs. Treatment affected the anterior 40% of the corneal stroma, based on full keratocyte depletion 1 week after treatment.…”

Section: Discussionmentioning

confidence: 84%

“…[22][23][24] Despite excellent clinical outcomes, the classic Dresden protocol is unsuitable for corneas thinner than 400 lm, owing to potential damage to the corneal endothelium and deep ocular structures. [5][6][7][8][9] WST-D has a peak excitation wavelength of approximately 755 nm in the NIR region, which provides deep tissue penetration, induces a low retinal response, and is safe to the eye for extended exposure at an irradiance of 10 mW/cm 2 .…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Biomechanical and Histologic Results of WST-D/NIR Corneal Stiffening in Rabbits, Up to 8 Months Follow-up

Brekelmans

Goz

Dickman

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Long-Term Biomechanical and Histologic Results of WST-D/NIR Corneal Stiffening in Rabbits, Up to 8 Months Follow-up

Brekelmans

Goz

Dickman

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…It was reported to stop the progression of ectasia, and studies reported persistent effects up to 7 years after treatment [2, 3]. Corneal CXL was also used to manage iatrogenic ectasias [3], pellucid marginal degeneration [19], infectious keratitis [4] or even bullous keratopathy [20].…”

Section: Discussionmentioning

confidence: 99%

“…Over the last 20 years, strengthening the biochemical and biomechanical properties of the cornea by collagen cross-linking (CXL) has become one of the very effective treatments to stop progression of keratoconus [1, 2], corneal ectasia [3], and even in the treatment of some forms of resistant infectious keratitis [4]. …”

Section: Introductionmentioning

confidence: 99%

Optimizing Genipin Concentration for Corneal Collagen Cross-Linking: An ex vivo Study

et al. 2018

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Purpose: Studying genipin variable concentrations, treatment durations, and delivery methods as a substance to increase corneal stiffness by inducing corneal collagen cross-linking (CXL). Materials and Methods: 100 bovine corneas treated with different genipin concentrations (0.1, 0.5, and 1%) and treatment durations (15 min, 40 min, 2 h, and 3 days) through different delivery methods compared to 10 controls treated with riboflavin/UV. Histology examination, enzymatic digestion with collagenase and thermal differential scanning calorimetry were performed on the different samples. Results: Bovine corneas soaked in 0.5% genipin morphologically showed 4.7% CXL in comparison to 5.6% in controls (p < 0.05). Corneas treated with topical 0.5% genipin, by a 140-µL drop applied hourly for 2 h, showed 7% corneal CXL. Corneas treated with topical genipin 0.5% for 30 min, 1 and 2 h showed 54 ± 6, 40 ± 7, and 39 ± 9% enzymatic degradation, respectively, in comparison to controls (74%). Corneas treated with 0.5% genipin for 1, 2, and 8 h showed higher thermal denaturation resistance (Td values of 64.9 ± 0.3, 64.7 ± 0.0 and 67.3 ± 0.9), respectively, in comparison to the control group (64.6 ± 0.5) (p < 0.05). Conclusions: Genipin 0.5%, in a 140-µL drop applied hourly for 2 h, showed better potential to enhance corneal stiffness and stability through inducing CXL.

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“…One can observe changes in the cornea in some patients, even after 7 years post a CXL procedure 35 . In our cohort, a minimum follow up of at least four months after CXL was chosen since it was clinically observed that in general topographies become stable at least four months after conventional CXL in keratoconus patients.…”

Section: Discussionmentioning

confidence: 99%

Corneal-Wavefront guided transepithelial photorefractive keratectomy after corneal collagen cross linking in keratoconus

Camellin¹,

Guidotti²,

Arba-Mosquera

2017

Journal of Optometry

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PurposeTo evaluate the efficacy and safety of Corneal-Wavefront guided transepithelial photorefractive keratectomy (TransPRK) after corneal collagen cross linking (CXL) in keratoconic patients.MethodsIn this retrospective, non-comparative, consecutive case series, 39 keratoconic eyes underwent Corneal-Wavefront guided TransPRK for the correction of aberrations at least 4 months after conventional CXL at SEKAL Rovigo Microsurgery Centre, Rovigo, Italy. Two eyes (5%) underwent a secondary laser retreatment for the improvement of post-operative visual acuity and were not included in this retrospective analysis. The mean age of the patients was 35 ± 12 years (19–64 years) at the time of the surgery. Keratron-Scout (Optikon) topographer was used for diagnostic tests and a flying-spot laser (AMARIS; SCHWIND eye-tech-solutions) was used for the refractive surgery. Complete ophthalmic examinations were performed before and after the surgery (4–36 months postoperatively with a mean follow up time of 10 ± 8 months).ResultsPreoperatively, eyes showed irregular astigmatism up to 8D. At last postoperative follow-up, 21 eyes (57%) had UDVA better than 20/40, and six eyes (16%) had UDVA of 20/20. Twenty-three eyes (62%) were within 1.50D of attempted correction in spherical equivalent (mean deviation from target was +1.09 ± 2.36D, range −2.50 to +7.38D). No eye lost 2 Snellen lines of CDVA, and 15 eyes (41%) had an increase of more than 2 lines.ConclusionsCorneal-Wavefront guided transepithelial PRK ablation profiles after conventional CXL yields to good visual, optical, and refractive results. These treatments are safe and efficacious for the correction of refracto-therapeutic problems in keratoconic patients.

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Corneal Cross-linking to Halt the Progression of Keratoconus and Corneal Ectasia: Seven-Year Follow-up

Cited by 118 publications

References 32 publications

Long-Term Biomechanical and Histologic Results of WST-D/NIR Corneal Stiffening in Rabbits, Up to 8 Months Follow-up

Long-Term Biomechanical and Histologic Results of WST-D/NIR Corneal Stiffening in Rabbits, Up to 8 Months Follow-up

Optimizing Genipin Concentration for Corneal Collagen Cross-Linking: An ex vivo Study

Corneal-Wavefront guided transepithelial photorefractive keratectomy after corneal collagen cross linking in keratoconus

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